The SGIM leadership has determined that the Society must take a leading role in the quality debate. Many SGIM members are conducting cutting-edge health care quality research at all levels of our health care system. We have developed a new quality initiative to synthesize these efforts to advance quality measurement. We plan to continue our efforts in refocusing the quality movement and pay for performance methodology by conducting a featured symposium at the SGIM 30th Annual Meeting. For this conference we are calling for presentations that will address various aspects of how complexity should impact quality measures. Our goal is to inform influential thought leaders in general internal medicine, regarding: Use of existing data to demonstrate how performance changes as patients have more diagnoses or medications. Use of existing data to evaluate performance as a function of socio- demographics. Evaluation of multiple quality indicators in the same patient, this might include weighting schemes or observations on how performance changes as the number of indicators increases. Methodologies for adjusting performance for complexity. The objectives of this symposium are to: (1) offer high-quality presentations representing the best work in the field; (2) provide state-of the-are research that will give us a roadmap for where the research is headed; and (3) present an economical research agenda to AHRQ and disseminate findings to the research community and other vested stakeholders. The Society of General Internal Medicine (SGIM) is requesting funds to support a featured symposium at the 30th SGIM Annual meeting to be held in Toronto, Canada from April 25-28, 2007 that will highlight the top 3 or 4 original abstracts submitted to the national meeting that relate to quality and complexity. Following the presentations, we will have a national quality research expert summarize the data and put the findings into both clinical and research context. Finally, we hope to present an economical research agenda to the research community and AHRQ at the national meeting. [unreadable] [unreadable] [unreadable]